Differential Diagnosis
The patient's symptoms of significant GI distress, weight loss, abdominal pain, and early satiety suggest a complex underlying condition. The following differential diagnoses are organized into categories:
- Single Most Likely Diagnosis
- Gastrointestinal malignancy (e.g., gastric or pancreatic cancer): The patient's significant weight loss, early satiety, and abdominal pain are concerning for a malignant process, particularly given the recent colonoscopy showing polyps and diverticulosis.
- Other Likely Diagnoses
- Peptic ulcer disease: The patient's abdominal pain and early satiety could be indicative of a peptic ulcer, which may be related to NSAID use or Helicobacter pylori infection.
- Gastroesophageal reflux disease (GERD): The patient's symptoms of early satiety and abdominal pain could be consistent with GERD, particularly if there is a history of reflux symptoms.
- Inflammatory bowel disease (IBD): Although the patient's colonoscopy was recently normal, IBD (e.g., Crohn's disease or ulcerative colitis) could still be a consideration, particularly if the patient has a family history or other risk factors.
- Do Not Miss Diagnoses
- Mesenteric ischemia: The patient's abdominal pain, weight loss, and early satiety could be indicative of mesenteric ischemia, which is a medical emergency requiring prompt intervention.
- Pancreatitis: The patient's abdominal pain and early satiety could be consistent with pancreatitis, which may be related to gallstones, alcohol use, or other causes.
- Gastric outlet obstruction: The patient's early satiety and weight loss could be indicative of a gastric outlet obstruction, which may be caused by a malignant or benign process.
- Rare Diagnoses
- Zollinger-Ellison syndrome: This rare condition is characterized by excessive gastric acid production and could cause the patient's symptoms of abdominal pain and early satiety.
- Eosinophilic gastroenteritis: This rare condition is characterized by eosinophilic infiltration of the gastrointestinal tract and could cause the patient's symptoms of abdominal pain and early satiety.
- Gastric lymphoma: This rare condition is a type of cancer that affects the stomach and could cause the patient's symptoms of weight loss, abdominal pain, and early satiety.